Cough: causes, types, diagnosis and management

Types and characteristics

Coughs are often described as "dry" (non-productive) or "productive" (bringing up sputum). Clinically, they are also classified by duration: acute (less than three weeks), subacute (three to eight weeks) and chronic (longer than eight weeks). The sound, timing (day or night), triggers and associated symptoms such as fever, breathlessness, voice change or weight loss help narrow possible causes.

Common causes

Many conditions can provoke coughing. Common triggers include:

• Respiratory infections (viral colds, bronchitis, pneumonia).
• Airway irritation from environmental pollutants such as dust or smoke.
• Chronic airway diseases like asthma or chronic obstructive pulmonary disease (COPD).
• Postnasal drip, gastroesophageal reflux disease (GERD), and certain medications (for example, ACE inhibitors).

Evaluation and management

Assessment begins with a medical history and physical examination. Tests may include chest imaging, spirometry, throat or sputum cultures and, when indicated, bronchoscopy. Treatment targets the underlying cause: antibiotics for bacterial infections, inhaled bronchodilators or corticosteroids for asthma, proton-pump inhibitors for reflux-related cough, and stopping offending medicines. Symptomatic options include expectorants to loosen mucus and antitussives to suppress troublesome dry coughs; these are used judiciously because suppressing a productive cough can impair clearance of secretions.

When to seek care and important considerations

Seek prompt medical attention for high fever, difficulty breathing, coughing blood, sudden chest pain or a cough lasting more than eight weeks. Persistent cough can spread respiratory infections and, in rare cases, cause complications such as rib strain, fainting episodes or sleep disruption. Preventive measures include smoking cessation, vaccination against influenza and pneumonia when appropriate, and reducing exposure to airborne irritants.

Notable facts: Cough is both a protective reflex and a common symptom across many disorders; careful evaluation helps distinguish harmless short-lived coughs from signs of significant disease.